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�,-- ELECTRICAL PERMIT APPLICATION <br /> �►' a CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov J www.everettwa.gov/permits <br /> PROJECT;.SITE:: NF <br /> PROJECT ADDRESS:& .o-{ ( �r� 2A <br /> BUILDING AREA(if residential, new construction, remodel,or addition) 3 SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR ATTACHED,UPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 2.49 p 0 ,} N p <br /> ..... : :................. ... .:......:.....: .................:...:........ <br /> CONTRACT PRICE OF WORK:$ , 9 �� k,5©p <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if a plicable): <br /> DESCRIPTION OF WORK: t ,orlA v Li 11 a c.c14-j 0--1A LA)-/r' <br /> CONTACT INFORMATION <br /> OWNER NAME:cef f I47 J ��C. CA(i TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET at-.\P (' .QOckiX E?2 ( <br /> cnY e`r(VY� 't STATE ZIP q.e() 7j <br /> OWNER PHONE: Ct/}-�T - I-j l(D OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> crw EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEAT!NG.COM <br /> CONTRACTOR LIC.#(REQUIRED): GSHTGSH930RK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019685 <br /> PRIMARY CONTACT: 0 OWNER 121 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252.-4402 <br /> DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM <br /> AGREEMENT::1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> )\CPINA,..V40 (bf3( / re EOwner/Authorizednt`Slgnature Date (Revised 9/23/2016) <br />